Monday, November 07, 2005

CHALLENGING DOGMA (Post #7): Smoking Should Be Banned in All Public Areas

One thing I don't think I've ever heard another tobacco control advocate say is that they oppose a proposed smoking ban. I guess I distinguished myself, for better or worse, when I came out last April (in the early days of this blog) against a proposed outdoor smoking ban in Corvallis. Since that time, I have written a number of posts opposing outdoor smoking bans (in Portland; in Buffalo Grove; and in general).

But I think it's safe to say that the general sentiment in the anti-smoking movement is that nonsmokers should simply not have to breathe in secondhand smoke in any public place and that laws should be enacted to ensure that is the case. That is certainly the impression that one gets if one looks at what is going on out there today.

The Washington state initiative (I-901) that bans smoking in all indoor workplaces, which voters will consider tomorrow (Tuesday, November 8), also bans smoking within 25 feet of any building in which smoking is banned, a provision that has apparently led many to question the reasonableness of the initiative.

A new public opinion poll in New York state found that a majority of citizens support banning smoking outdoors, prompting the director of the Center for a Tobacco-Free New York to state: "I had no idea it was going to get this kind of support. It gives you an idea of how obnoxious some people find it."

That same study led the executive director of a national nonsmokers' rights group to suggest that "limiting smoking outdoors is the next logical step in the anti-smoking movement. It shouldn't be at all surprising. I think the new frontiers in terms of nonsmokers' rights are outdoors and also protecting children in cars and their own homes."

And the public opinion study prompted a state Representative to suggest that the public sentiment in favor of banning smoking outdoors might just lead him to offer such a proposal: "'I'm surprised how strong the sentiment is for this, and if it is there, of course we will be looking into it,' said Assemblyman Alexander 'Pete' Grannis (D-Manhattan), who wrote the Clean Indoor Air Act. 'The numbers show there is support for further limitations.' In recent years, Grannis introduced legislation to ban smoking in parks and on beaches to limit litter, but he said he would now amend that bill based on the new data."

Just Friday, it was reported that the Carmel (California) City Council voted to ban smoking "within the boundaries of Carmel Beach, the beach bluff pathway or any walkways or stairways adjoining beach areas." According to the article, the city's mayor stated that the outdoor smoking ban "is a motherhood type thing. You can't be against it."

And a program manager at Americans for Nonsmokers' Rights wrote just last week in a USA Today commentary: "It's time to protect our right to breathe clean indoor air. It's hard to achieve that goal, though, when smoke filters in through doorways and windows of buildings from the outside."

That commentary was in opposition to a USA Todayeditorial which supported indoor smoking bans, but suggested that outdoor bans were taking things too far: "These days, however, laws pending or just passed around the USA exile outdoor smokers -- a step that advances the anti-smoking crusade, long supported in this space, into questionable territory."

The Rest of the Story

Motherhood or not, I oppose outdoor smoking bans, except for certain cases where smoking is being regulated in an enclosed place or one in which people cannot easily move to avoid the smoke (such as an outdoor stadium where people are in fixed seats). But for the most part (e.g., bans on smoking in all parks, beaches, or other open outdoor areas), I oppose these measures.

I also find regulating smoking outside of buildings in which smoking is banned to be going too far.

Why?

To understand my reasoning, perhaps I need to first explain the reasons why I support indoor smoking bans. I simply feel that the scientific evidence is sufficient to conclude that exposure to secondhand smoke in an enclosed indoor environment is a substantial health hazard to employees in that environment, and that the use of the police power to protect the public's health and in particular, the right of employees to make a living and support themselves and their families without having to face an easily preventable health hazard is therefore justified.

Now I realize that many of my readers may differ in their opinion of the nature of the scientific evidence and I respect that difference of opinion and the resulting difference in opinion on whether the use of the state's police powers are justified.

But the point is - at least I can claim to be relying on a body of scientific evidence that supports my assertion that the problem is a serious enough one to warrant government intervention to protect the rights of workers to a safe working environment.

The same is simply not the case, I believe, of anti-smoking advocates who are pushing for outdoor smoking bans in non-enclosed areas.

I am simply not aware of any substantial body of scientific evidence that demonstrates exposure to secondhand smoke in non-enclosed outdoor environments to be a significant public health problem, certainly not great enough of a problem that it would justify the use of the state's police powers to rectify that problem.

And I'm also not aware of any substantial evidence that smoke "filtering in through doorways and windows of buildings from the outside" is a significant threat to health.

In addition, while I believe that the government does have a responsibility to provide workers with a safe working environment (one reasonably free of preventable hazards), I don't believe that there is any such responsibility when it comes to the public wandering about outside. Certainly, the burden of harm (the level at which the government would be justified in legislating a solution to the problem) is tremendously higher in this type of setting compared to an enclosed workplace.

So I reject the notion (the dogma, I think) that smoking should be banned in all public areas.

I have been working for smoke-free indoor workplaces for 21 years, and I yield to no one in my efforts to accomplish this goal. Yet I am now publicly opposed to most outdoor bans and to the very idea that somehow the ultimate goal is to eliminate smoking in all public places, regardless of the scientific evidence on whether or not there are substantial hazards involved.

Perhaps what troubles me the most is the implied notion that the goal is something other than achieving smoke-free workplaces for all workers. That is certainly the way I have tried to frame the problem and the solution in my 21 years working on the issue.

But the way the issue is being framed now, it seems that something more is at stake. It seems that anti-smoking advocates are pushing for something far more extreme - the virtual elimination of smoking in all places outside the private home (and even that doesn't seem enough to satisfy groups like Action on Smoking and Health, which intimated that the next frontier will be protecting children in "their own homes").

To me, there is no frontier. I see this merely as an effort to provide safe workplaces. Once (and if) that is accomplished, it's over for me. But I don't get the sense that it will ever be over for anti-smoking groups and advocates.

Equally troubling is the notion that because the public now seems to support outdoor smoking bans, we should go ahead and institute them. To me, it doesn't matter whether the public supports such bans. If they are not justified, then they are not justified, whether the public would support them or not.

But perhaps most troubling to me is the absolute lack of scientific data upon which these public policies are being promoted. I have reviewed literally hundreds of articles about the hazards of secondhand smoke in indoor work settings, but I've never seen any evidence that smoke seeping into buildings from open windows or doors is a serious health threat. Or that smoking in a public park is a serious health threat that justifies government intervention.

I agree with the USA Today's editorial, but I would take it one step further. I don't think that outdoor smoking bans "advance the anti-smoking crusade ... into questionable territory." I think that in most cases, these bans advance the crusade into unquestionable territory - unquestionably bad and unjustified public policy.

I realize that I'm going to face attack from many of my colleagues for expressing these views and that many will suggest that I am harming the movement by speaking out like this. But ultimately, I believe that the advancement of the smoke-free air movement into open outdoors areas is what most threatens the movement right now. Because I think at some point people are going to just say that they've had enough. And then the whole movement, even what I see as its legitimate aspects, are going to come to a grinding halt.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.